Elderly care services in Australia are being maintained mainly through non-profit organizations that provide in-home caretaker scheduled visits, temporary care facilities (adult daycare), and living facilities for both independent elders, and those who need assistance. The demographic profile of people who access these services has undergone significant changes, and there was a strong need to reform this part of public services. In Australia, the framework for ensuring that this type of service will be provided on an adequate level of quality was first developed in 1997.
In the past decade, this framework has been deemed ineffective due to various mishaps and hindsight in its original form. Despite the need for accreditation for elderly care facilities, the quality of services has experienced insignificant improvements (Thomas & Butler, 2017). This situation led to the establishment of the Royal Commission into Aged Care Quality and Safety in October 2018, and the new standards of care, which are used since 1 July 2019. The purpose of this paper is to analyze the new Aged Care Quality Standards and discuss their intents and effectiveness.
The framework for elderly care facilities is a set of mandatory principles and guidelines that a facility has to follow to warrant that its customers receive the best attainable care. The Aged Care Quality Standards consist of 8 individual requirements for elderly care organizations, all of which are aimed at improving the safety, health, well-being, and autonomy of their customers. The Aged Care Quality and Safety Commission (2019) in its guidance handbook states that “The Quality Standards focus on outcomes for consumers and reflect the level of care and services the community can expect from organizations” (p.2). These standards are described in three crucial points, which include a point of view from a customer’s perspective, an organization’s perspective, and a description of what a compliant organization should look like.
The new Aged Care Quality Standards are meant to eradicate or ameliorate past issues in elderly care principles. Henderson et al. (2016) state that this type of service “is primarily privately owned and subsidized by the government”, and the non-profit sector “provided 57% of residential aged care beds in Australia in 2012” (p. 413). Henderson et al. (2016) conclude that “staffing levels, resident acuity, and skill mix were identified as major reasons for missed care in both quantitative and qualitative responses” (p. 416). Studies reported a vast amount of missing care opportunities, a lack of diversified skill sets, and insufficient knowledge of caretaking in personnel (Henderson et al., 2016). These problems are addressed in the new standards and organizations that receive government funding in 2020 should not have any of them. Unlike the principles that were set by the Aged Care Act 1997, the introduced standards are significantly more person-centered and allow people to have considerable influence on their lives.
These standards are listed as the following:
- The organization has to engage its clients in the choice-making process and treat them with dignity and respect.
- The organization has to work with its customers on a partnership level by including them in the planning and assessment of their care.
- The organization has to provide optimal clinical and personal care while taking patients’ preferences and goals into consideration.
- Services and supports that are provided by the organization must be safe and effective and aim to upkeep its customers’ well-being and independence.
- The environment of the organization has to be safe and well-maintained.
- Customers should be encouraged to leave comments and feedback and make complaints if necessary. The organization has to improve its services based on these complaints immediately.
- The staff of the organization has to be well-trained for its job, as well as show care, respect, and support for its customers.
- The organization has to take responsibility for its services, nurture a positive atmosphere for interactions, and strive for improvement.
The Aged Care Quality and Safety Commission (2019) emphasizes that this handbook “does not purport to provide comprehensive guidance” of best possible practices, and organizations are expected to maintain these standards according to their specifics (p.3). Elderly care facilities should be referring to this resource while also should not forget about any other specific requirements to their provided services from the health care or legal laws in Australia.
The broad relevance of these standards guarantees that every organization is on par with the set quality level, no matter what type of services it provides. Cumming et al. (2019) state that many of these changes “stem from the active involvement of consumers in the design and implementation” (p.4). The Aged Care Quality Standards are set to be sustainable for an extended period and can accommodate new technologies in their recommendations.
Clients of such organizations are expecting qualified, knowledgeable, and caring personnel, a well-structured organization, and a suitable residential area that suffices all clients’ needs and supports their way of living. In turn, organizations that uphold these standards receive proper government funding, support in decision-making, and improved professional education (Cumming et al., 2019). Moreover, it is expected that the strain on the healthcare system will be reduced from these changes, as there will be fewer incidents of prescription of unnecessary or harmful medications, and more well-trained clinical staff in elderly care facilities (Cumming et al., 2019). Therefore, this framework ensures that both Australian citizens and the government will benefit from the aforementioned changes.
These standards are mandatory, starting from 1 July 2019, and the Aged Care Quality and Safety Commission is now actively assessing all accredited facilities. To monitor compliance of organizations with the new Aged Care Quality Standards, the Royal Commission will be evaluating consumer outcomes and satisfaction, as well as knowledge and understanding of these principles by working personnel (The Aged Care Quality and Safety Commission, 2019). There are several methods in use to gather full data on the organization’s level of compliance: review audits, self-assessment, and site audits. The innovative technologies are being used to analyze the results and guarantee quality feedback (Sluggett et al., 2017). The need for re-accreditation can be a result of any suspicions and reports about an organization that does not comply with said standards.
However, this framework has several potential issues which might hamper its effectiveness. There are concerns regarding aged care organizations that do not receive any funding from the government, as they have little incentive to comply with these standards (Thomas & Butler, 2017). The inclusion of best evidence-based practices in mandatory rules is also lacking, which could lead to stagnation (Thomas & Butler, 2017). Moreover, positive outcomes could be challenging to analyze due to the subjectivity of data accurately.
Facilities that provide therapeutic recreation are also affected by the new set of standards of care. Some aged care organizations that work with persons with disabling conditions or illnesses, to whom therapeutic recreational activities are essential, are now obliged to add access to this type of service to adhere to these standards. Standards 3 and 4 explicitly state that to satisfy customers’ needs, the organization has to provide all the necessary means for customers’ well-being.
In conclusion, the new Aged Care Quality Standards were necessary, perhaps even overdue implementation. Their purpose is not only to guarantee customers’ safety, well-being, and satisfaction but to generally improve the workflow of elderly care facilities. Within this setting, organizations can grow in the quality and efficiency of providing care and acquire necessary feedback for further upgrades. The Australian government has set a strict ruleset, which can be difficult to uphold, but it is beneficial for all involved parties. These standards thoroughly describe what should organisations aim for, and what to expect from governmental monitoring.
The Royal Commission into Aged Care Quality and Safety took into account most of the past mistakes and significantly shifted the vector of the new rules into customers’ favor. They give consumers the power to change the caretaking process to suit their needs, as well as protect their interests according to their level of independence. Therefore, these standards guarantee not only adequate but high-quality clinical and personal care for each customer’s needs. Therapeutic recreation is now a necessary part of the caretaking process for organizations that work with people who require this type of service. The Aged Care Quality Standards ensure further chances to improve the living conditions of older adults and optimize the entire healthcare system.
References
Cumming, A., Thompson, J., Grosvenor, S., & Kurrle, S. (2019). NHMRC partnership centre on dealing with cognitive and related functional decline in older people: Submission to the Royal Commission into Aged Care Quality and Safety. Cognitive Decline Partnership Centre.
Henderson, J., Willis, E., Xiao, L., & Blackman, I. (2017). Missed care in residential aged care in Australia: An exploratory study.Collegian, 24(5), 411-416.
Sluggett, J. K., Ilomäki, J., Seaman, K. L., Corlis, M., & Bell, J. S. (2017). Medication management policy, practice and research in Australian residential aged care: Current and future directions. Pharmacological Research, 116, 20–28.
The Aged Care Quality and Safety Commission. (2019). Guidance and resources for providers to support the Aged Care Quality Standards. Web.
Thomas, L., & Butler, A. (2017). Single aged care quality framework – Draft Aged Care Quality Standards consultation paper 2017 and Options for assessing performance against Aged Care Quality Standards, options paper 2017. Australian Nursing & Midwifery Federation.